The nurse caring for the client diagnosed with sickle cell crisis places priority on which specific goal(s) prior to discharge? (SELECT ALL THAT APPLY)

Decrease fluid intake of 1000 mL/day to prevent fluid overload

The client verbalizes the procedure for a 24-hour urine collection

Oxygenation and perfusion to meet cellular and metabolic needs

Complications are prevented or minimized

Pain is relieved or controlled

Answer and Explanation

Correct Answer : C,D,E

A. Decrease fluid intake of 1000 mL/day to prevent fluid overload: This goal is not appropriate. Clients with sickle cell crisis often require increased fluid intake to prevent dehydration and promote circulation, so limiting fluids is counterproductive.

B. The client verbalizes the procedure for a 24-hour urine collection: While understanding this procedure may be relevant for monitoring kidney function or hydration status, it is not a priority goal directly related to managing sickle cell crisis.
C. Oxygenation and perfusion to meet cellular and metabolic needs: Ensuring adequate oxygenation and perfusion is crucial in managing sickle cell crisis, as compromised blood flow can exacerbate pain and lead to further complications.

D. Complications are prevented or minimized: Preventing complications, such as infections or acute chest syndrome, is a key goal in managing a client with sickle cell disease, making this a critical aspect of discharge planning.

E. Pain is relieved or controlled: Pain management is a primary focus during a sickle cell crisis. Ensuring that pain is effectively managed before discharge is essential for the client's comfort and overall well-being.

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Correct Answer is C

Explanation

A. Neutrophils 57%: This value reflects the percentage of neutrophils in the white blood cell count and does not specifically indicate the effectiveness of iron therapy. It is more related to the body’s immune response.

B. International Normalized Ratio (INR) 13 seconds: INR is a measure of blood coagulation and is not directly related to iron levels or the treatment of anemia. Therefore, this result does not indicate the success of ferrous sulfate therapy.

C. Total reticulocyte count 2.2% of total RBC count: An increased reticulocyte count indicates that the bone marrow is producing more red blood cells, which is a positive response to iron supplementation. A reticulocyte count around this percentage suggests an appropriate response to therapy for iron deficiency anemia.

D. Platelet count 250,000/µL: This is a normal platelet count and does not provide information specific to the effectiveness of iron therapy. It does not reflect the state of anemia or the response to iron supplementation.

A. express no complaints of chest discomfort or shortness of breath. B. discuss which lifestyle modifications will be necessary to maintain health. C. have clear breath sounds bilaterally upon auscultation. D. have a urinary output of greater than 30 ml per hour for 24 hours.

Correct Answer is A

Explanation

A) Express no complaints of chest discomfort or shortness of breath: This outcome directly relates to the goal of improving tissue perfusion. Chest discomfort and shortness of breath can indicate inadequate perfusion, particularly in a client with coronary artery disease. By achieving this outcome, the nurse can assess that tissue perfusion is sufficient and the client is stable.

B) Discuss which lifestyle modifications will be necessary to maintain health: While this is an important aspect of ongoing care and management for coronary artery disease, it does not directly address the immediate concern of impaired tissue perfusion. The priority is to ensure the client is currently experiencing effective perfusion rather than just planning for future health modifications.

C) Have clear breath sounds bilaterally upon auscultation: Clear breath sounds are a positive indicator of pulmonary function but do not directly measure tissue perfusion related to coronary artery disease. While this is important for overall health, it does not specifically target the issue of impaired perfusion in cardiac tissue.

D) Have a urinary output of greater than 30 ml per hour for 24 hours: While adequate urinary output can be a sign of good kidney perfusion and overall fluid balance, it is not a direct indicator of cardiac tissue perfusion. The priority in this scenario is more closely tied to the client’s cardiac status and symptoms related to coronary artery disease.

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The nurse caring for the client diagnosed with sickle cell crisis places priority on which specific goal(s) prior to discharge? (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

A client has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?

Correct Answer is C

Explanation

The nurse, who is caring for a client diagnosed with coronary artery disease, prioritizes the problem of impaired Tissue Perfusion into the plan of care. Which expected outcome would be most appropriate? The client will:

Correct Answer is A

Explanation

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The nurse is reviewing the laboratory test results of a client with long standing hypertension. Which result would be of most concern to the nurse?

The client with coronary artery disease asks the nurse. "Why do I get this chest pain?" Which would be the most appropriate response?

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The nurse reviews the newly written prescriptions for a client admitted with the diagnoses of coronary artery disease and hypertension. Which prescription should the nurse implement first?

The nurse caring for the client diagnosed with sickle cell crisis places priority on which specific goal(s) prior to discharge? (SELECT ALL THAT APPLY)

Isosorbide mononitrate modified release formula is structured to provide a nitrate free period. The nurse understands that the rationale for this period is to: